Diagnosis of Ovarian Cancer by Confocal Microendoscopy

描述(申请人提供)：本研究的目标是进一步开发和临床验证实时多光谱共聚焦显微内窥镜，用于活体诊断卵巢癌。共焦显微内窥镜是一种在细胞水平上显示组织的新型仪器，在光学活检方面显示出巨大的前景。共焦显微内窥镜有可能为医生提供对组织的即时评估，并调查更大的组织面积，减少传统组织提取活检的抽样误差。在之前的资助期间，构建了一个共聚焦微型腹腔镜系统，并在人体内进行了测试。这项工作的一个具体目标是现在验证该系统，并证明它可以用于在腹腔镜手术中检测卵巢癌。这项工作的其他目标是将该仪器的使用扩大到检测整个腹腔内的卵巢癌腹膜种植，并开发和测试一种能够在输卵管内成像的系统。进一步的技术发展旨在改善共焦成像性能，并增加光学相干层析成像作为一种补充成像方式。新仪器将把这两种成像模式合并到一个紧凑的探头中，可以在操作模式之间无缝快速切换。除了技术开发和临床翻译外，该项目的另一个目标是开发和测试靶向造影剂，提供更安全和更有效的体内卵巢癌识别。 公共卫生相关性：这项研究的目标是证明共焦微型腹腔镜在卵巢癌诊断中的临床潜力。共焦微型腹腔镜是一种对组织进行光学活检的仪器。这项技术是在前一个供资期间卵巢癌检测的背景下开发和临床演示的。继续工作的目的是验证卵巢癌检测仪器的临床性能，并将其临床应用扩大到输卵管和腹膜腔内转移性卵巢癌的成像。还建议改进和扩大仪器的能力，并开发可在临床环境中安全和有效使用的靶向造影剂。

DESCRIPTION (provided by applicant): The objective of this research is to further develop and clinically validate a real-time multispectral confocal microendoscope for in vivo diagnosis of ovarian cancer. The confocal microendoscope is a new type of instrument for visualizing tissue at the cellular level and has shown great promise for performing optical biopsy. Confocal microendoscopy has the potential to provide a physician with an immediate evaluation of tissue and to survey a much greater area of tissue, reducing the sampling error of traditional tissue extraction biopsy. A confocal microlaparoscope system was constructed and tested in vivo in humans during the prior funding period. A specific aim of this work is to now validate the system and show that it can be used to detect cancer of the ovary during a laparoscopic procedure. Additional objectives of the work are to expand the use of the instrument to the detection of peritoneal implants of ovarian cancer throughout the abdominal cavity and to develop and test a system capable of imaging inside the fallopian tubes. Further technical development is aimed at improving the confocal imaging performance and adding optical coherence tomography as a complimentary imaging modality. The new instrument will incorporate the two imaging modalities into a single compact probe with seamless and rapid switching between modes of operation. In addition to the technology development and clinical translation, another aim of the project is to develop and test targeted contrast agents that provide safer and more effective in vivo identification of ovarian cancer. PUBLIC HEALTH RELEVANCE: The goal of this research is to demonstrate the clinical potential of the confocal microlaparoscope for the diagnosis of ovarian cancer. The confocal microlaparoscope is an instrument for performing optical biopsy of tissue. The technology was developed and clinically demonstrated in the context of ovarian cancer detection during the previous funding period. Continuing work is aimed at validating the clinical performance of the instrument for the detection of ovarian cancer and expanding the clinical applications to imaging of the fallopian tube and metastatic ovarian cancer in the peritoneal cavity. Work is also proposed to improve and expand the capability of the instrument and to develop targeted contrast agents that can be used safely and effectively in the clinical setting.